Reliability and security of implantable and wearable medical devices

Implantable and wearable medical devices (IWMDs) are used for monitoring, diagnosis, and therapy of an ever-increasing range of medical conditions, leading to improved quality of life and outcomes for patients. Advances in the use of IWMDs have been accompanied, and in great part enabled, by increases in their functional complexity, wireless connectivity to allow for postdeployment monitoring, and programmability to allow therapy to be tuned to the evolving needs of each patient. These factors have also led to a rapid growth in concerns about reliability and security of IWMDs, as underscored by recent trends in warnings and recalls of IWMDs due to failures, and a series of successful attacks on IWMDs demonstrated by academic researchers and the hacker community. The unique usage models of IWMDs and the need to provide very high levels of reliability and security under very stringent resource constraints set them apart from other classes of computing platforms. In this chapter, we present the reliability and security challenges faced by designers of IWMDs. We discuss how patient safety and privacy can be compromised by failures of, and security attacks on, the electronic hardware and software within IWMDs. We survey the potential solutions that have been proposed to address these challenges and discuss their merits and limitations.